Marshaling Resources to Stop AIDS Epidemic

Two leading advocacy organizations have issued a new report outlining their plan to bring an end to the HIV/AIDS epidemic. The report is being released ahead of the 19th International AIDS Conference in Washington, also known as AIDS 2012.

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AVAC and amFAR, the Foundation for AIDS Research, have published An Action Agenda to End AIDS – a combination of short and long term goals.

“The last several years have delivered some of the most exciting science in 30 years of the epidemic. And taken together, they point us in a direction that the idea of ending the epidemic is not just the pipedream, the vision we all wanted to have over the last several decades. It’s actually real. The science tells us it’s possible,” said Mitchell Warren, executive director of AVAC, previously known as the AIDS Vaccine Advocacy Coalition.

That science includes proving that antiretroviral drugs can not only save and prolong lives, but can actually prevent infection in the first place; demonstrating great strides in microbicide research that could empower women to protect themselves from HIV; and recent studies showing that a vaccine is indeed possible.

“The pieces of the puzzle are beginning to come together. But we have to wonder if we as advocates and policymakers and researchers will have the wisdom to put the pieces together properly. And what we’ve tried to do with amFAR is [to] lay out the critical actions that over the next several years might begin to translate the science into impact,” he said.

The groups’ “action agenda” lists one essential step as making the hard choices.

“If we don’t act in the next two, three, four years, to really make the hard choices, we are going to find ourselves in a much more difficult position to make hard choices in three or four or five years because the number of infections is mounting,” said Warren.

Other steps include “mobilizing sufficient, sustainable resources” to ensure that critical interventions are scaled-up and not cut back.

“We’ve seen these incredible increases over the last decade of resources for AIDS, for treatment, for prevention, for global health generally. And for the first time we’re beginning to see the leveling off of resources. We’re now looking at levels in 2012 that look like 2008 [and] 2009 both for implementation as well as for research and development. And that’s hugely worrisome,” he said.

Warren talks of the tipping point in the epidemic. He says it can be reached by putting more people on treatment and making proven prevention methods widely available. The tipping point comes when there are more people on treatment than are being newly infected. But that means spending more in the short-term at a time when budgets are very tight.

“If this were a business – if AIDS were a business – this would be the best time to invest. We have the great insights around the science and the beginnings of understanding [of] what’s working. And if we don’t double-down on the investments of what’s working now, we’re going to put ourselves further back in this fight,” he said.

“Agreeing on clear goals and responsibilities” are listed in the report as other essential steps to end the epidemic.

Warren said, “We need real-time monitoring month by month, quarter by quarter. So we need to know that if we’re not achieving higher targets for people on antiretroviral treatment, or if we’re not getting more young men into programs where they can choose voluntary male medical circumcision – if we don’t start seeing the numbers on the monthly and quarterly basis -- we can’t make the course corrections to manage our resources strategically.”

He said too often monitoring progress is done only every two years to coincide with the cycle of funding for grants.

Warren added that it’s easy to envision having an AIDS-free generation as stated by President Obama and Secretary of State Clinton. He says it’s a lot harder to actually set a target date to achieve that goal.